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Osteonecrosis risk may reduce more after ORIF vs CRIF for femoral neck fractures
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Patients who underwent open reduction and internal fixation compared with closed reduction and internal fixation for treatment of pediatric femoral neck fractures had a higher fracture reduction quality and reported fewer complications, including osteonecrosis, according to results of this study.
Researchers used the International Classification of Diseases, Ninth Revision codes to identify 22 patients who with an average age of 11.5 years, underwent treatment for femoral neck fractures. Patients were followed for a mean of 2.1 years. Six patients were treated with open reduction and internal fixation (ORIF) and 16 patients were treated with closed reduction and internal fixation (CRIF). Evidence of osteonecrosis was found with postoperative radiographs and then graded with Ratliff criteria. In addition, investigators also graded reduction quality.
A professional research assistant assessed final outcomes for pain, movement, activity and radiographic appearance. Fisher’s exact test and Wilcoxon test were used to compare groups.
Results showed 50% of hips treated CRIF had osteonecrosis compared with 0% of hip for patients treated with ORIF. Patients who underwent ORIF compared with those who underwent CRIF had a higher reduction quality (83% vs. 13%) and rate of anatomic union (100% vs. 33%). Major complication rates were lower in the ORIF group compared with patients in the CRIF group.
According to the researchers, the groups did not significantly differ in Ratliff clinical and radiological assessments.‒ by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.
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